Helicobacter pylori in relation to asthma and allergy modified by abdominal obesity: The HUNT study in Norway

Abstract

Objective It is unknown whether the decreasing prevalence of H. pylori infections is associated with the increase in obesity and asthma and allergy. In this study, we assessed if obesity plays an intermediate role between H . pylori infections and allergy. Design A population-based, nested case-control study of 10,005 participants within the second Nord-Trøndelag Health Study (HUNT2), Norway, was performed in 1995–1997. The presence of H. pylori was tested by an enzyme immunoassay Pyloriset EIA-IgG, and weight, height, and waist circumference were measured. Body mass index (BMI) and waist circumference were used as measures of general and abdominal obesity, respectively. Self-reported asthma and allergic diseases were collected through questionnaires. The odds ratios of H. pylori relative to asthma and allergic diseases were estimated by logistic regression models stratified by waist circumference categories. Results H. pylori infection was present in 31%, ever asthma was reported in 10.4% and allergic rhinitis in 16.2%. The mean BMI was 26.4 ​kg/m 2 and the mean waist circumference was 86.6 ​cm. H. pylori infection was neither associated with asthma nor allergic diseases. However, when stratified by waist circumference, H. pylori infection was associated with 30–40% reduced odds of asthma and 25% reduced odds of allergic diseases in individuals with abdominal obesity (waist circumference ≥86 ​cm in women and ≥96 ​cm in men). Conclusion H. pylori infection is associated with reduced risk of asthma and allergy in individuals with abdominal obesity, suggesting a possible causal pathway from reduced H. pylori infections through obesity to increased risk of asthma and allergy.

Eradication of Helicobacter pylori and Gastric Cancer: A Controversial Relationship

“…This suggests that H. pylori infection can lead to a Th1-polarized immune response, as IL-4 is a cytokine that induces characteristic Th2 responses ( Bamford et al, 1998 ; Sommer et al, 1998 ). On this basis, through suppression of the Th2 response, H. pylori infection might also decrease the risk of asthma and allergies ( Ness-Jensen et al, 2019 ). Therefore, those in support of the hygiene hypothesis believe that it will not only be the relatively bacteria-free environment in early life, but also the use of antibiotics that increases the risk of autoimmune disorders in later life ( Miftahussurur et al, 2017 ).…”

Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)

“…By affecting immune and inflammatory responses [ 78 , 92 , 431 , 432 , 433 ]. HPI may protect against asthma and allergy (particularly in children), autoimmune disorders (systemic lupus erythematosus, rheumatoid arthritis [RA] and multiple sclerosis, coeliac disease), inflammatory bowel disease (especially Crohn’s disease), eosinophilic esophagitis, eczema, obesity [ 9 , 78 , 342 , 433 , 434 , 435 , 436 , 437 , 438 , 439 , 440 , 441 ] and tooth loss [ 442 ]. Negative associations between these diseases and HPI (beneficial effects) were observed mainly in patients colonized with cagA+ strains of H.p.…”

Review: Extragastric diseases andHelicobacter pylori

“…In a case-control study, including more than 10 000 patients, H pylori infection was found in 31%, asthma in 10.4%, and allergic rhinitis in 16% of the patients, but without any significant association; however, in patients with abdominal obesity, H pylori infection was associated with a 30%-40% reduced OR of asthma and a 25% reduced OR of allergic disorders. 91 Moreover, in a case-control study of 27 paediatric patients with asthma and 54 controls, an inverse association between H pylori and asthma was found (OR 0.1, 95% CI, 0.039-0.305; P = .026). 92 In a cohort study, 16% of children who were uninfected at 2 and 10 years of age developed asthma at 16 years vs none of those with H pylori infection at 2 years of age.…”